Follow-up of breast cancer: why is it necessary to start a Consensus in 2024?
Stefania Gori,
Alberto Zambelli,
Catia Angiolini,
Antonella Ferro,
Fiorenza De Rose,
Alessandra Fabi,
Giuseppe Azzarello,
Giuseppe Bogina,
Maurizio Cancian,
Matteo Valerio,
Michela Cinquini,
Fabrizio Nicolis,
Giovanni Pappagallo
Affiliations
Stefania Gori
UOC Oncologia Medica, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona - Italy and Associazione Italiana dei Gruppi Oncologici Multidisciplinari (AIGOM), Genova - Italy
Alberto Zambelli
Oncologia Medica all’Humanitas University; Capo sezione Senologia oncologica, Centro Oncologico Humanitas IRCCS di Rozzano (MI) - Italy
Catia Angiolini
Centro Senologia AOU Careggi - Breast Unit, Firenze - Italy
Antonella Ferro
SS DH Oncologia, coordinatore Breast Unit, Ospedale Santa Chiara, Trento - Italy
Fiorenza De Rose
UO Radioterapia Oncologica, Ospedale Santa Chiara, Trento - Italy
Alessandra Fabi
UOSD Medicina di Precisione in Senologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma - Italy
Giuseppe Azzarello
UOC Oncologia-Ematologia Oncologica del Distretto Mirano-Dolo, Ulss 3 del Veneto - Italy
Giuseppe Bogina
UOC Anatomia Patologica e Biologia Molecolare, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona - Italy
Maurizio Cancian
Società Italiana di Medicina Generale e delle Cure Primarie (SIMG), Medico di Medicina Generale, Conegliano (TV) - Italy
Matteo Valerio
UOC Oncologia Medica, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona - Italy
Michela Cinquini
Istituto di Ricerche di Farmacologiche Mario Negri IRCCS, Milano - Italy
Fabrizio Nicolis
Associazione Italiana dei Gruppi Oncologici Multidisciplinari (AIGOM), Genova - Italy and Direzione Sanitaria, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona - Italy
Giovanni Pappagallo
Coordinatore Scuola Metodologia Ricerca Clinica, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona - Italy
In Italy, breast cancer is the most frequently diagnosed cancer in women, with 55,900 new cases in 2023 (over 90% in the early stages). Due to the screening, early diagnosis and adjuvant treatment, these patients have a 5-years survival rate of 87% after the diagnosis. There are 834,154 women in Italy with a previous diagnosis of breast cancer: most of these women require a follow-up. The AIOM, ESMO and ASCO Guidelines recommend for early breast cancer (EBC) a clinical follow-up with only physical examination (and eliciting of symptoms) and an annual X-ray mammography, on the basis of the results of two randomized trials published in 1994 that showed no benefit in overall survival with intensive follow-up. However, an Italian survey reported the application by 80% of oncologists of an intensive follow-up based on the individual patient’s risk of recurrence. In fact, the oncologists believe that an early diagnosis of locoregional or distant recurrence may allow an early start of very effective therapies. In this lack of up-to-date scientific data, many questions about follow-up remain unanswered and the few ongoing studies will provide results in several years. Non-compliance with guideline recommendations leads to increased costs for the healthcare system. Furthermore, management varies widely from centre to centre with regard to guideline recommendations, resulting in inequalities between patients. For these reasons, the follow-up of breast cancer should be reconsidered. In the absence of recent scientific evidence, a multidisciplinary group of breast cancer experts has initiated a Consensus on the follow-up of EBC according to the mini-Delphi methodology. The project will be completed by the end of 2024.
